What are the lacrimal glands?
The lacrimal glands produce tears and normally sit under the outer part of the eyebrows. You may notice fullness of the outer part of the upper lids if they prolapse.
What causes the lacrimal glands to prolapse?
The tissues that hold the lacrimal gland in place become thinner and weaken with age. It can also occur in problems such as thyroid eye disease.
What is the treatment for lacrimal glands prolapse?
The NHS sets out criteria for what will be funded for surgery. Prolapsed lacrimal gland surgery is rarely funded. For cosmetic surgery, usually both sides are operated on and usually in conjunction with upper lid blepharoplasties. The lacrimal gland can be accessed through the skin crease of the eyelid, and is then repositioned with stitches. If there are any suspicious features Mr Lin will take a biopsy. At the end of the operation antibiotic ointment is used in the eye and a dressing is applied. You will be given the ointment to use at home.
What happens after the operation?
Written instructions will be provided for you. The key aftercare aspects are to minimise infection, bleeding/bruising, swelling and discomfort. Before you leave you will be given lubricating drops for the eyes and antibiotic ointment for the wounds to use for a few weeks after the surgery. You should not drive yourself home. Clean the eyelids gently with cooled, boiled water. If your eye feels sore when the anaesthetic wears off, take paracetamol. Avoid aspirin as this will encourage bleeding. Normally, the discomfort will settle within a few days. Ice packs (such as frozen peas wrapped in a clean towel) will reduce pain and swelling, and sleeping with more pillows to keep the head elevated will help.
You may start driving and working again as soon as the dressing is removed, as long as your vision is clear and you are not light-sensitive. Most forms of light exercise and a normal work pattern may be resumed within a few days of surgery. Avoid heavy lifting, running or strenuous work-outs for four weeks as you may worsen any bruising or swelling. Eyelid makeup can be worn once any scabs fall off. Mr Lin will remove the stitches after 1 week. You cannot wear contact lenses for at least two weeks after surgery, as the eyelids may be stiff/sore, and your eye surface may be dry.
If you have severe pain, not relieved by simple painkillers, please contact Mr Lin on his mobile phone as provided.
Eyelids normally heal very well and the wound is usually hidden in the natural skin crease of the lid.
What problems can occur after the operation?
Mr Lin performs many hundreds of eyelid operations per year and will draw on his expertise to minimise the risk of problems.
• Bruising and swelling of the eyelids is normal. The surface of the eye may also swell. These changes will settle after a few weeks, and will take longer to resolve in patients with blood thinners.
• Dry, gritty, sensitive eyes for a few weeks can be helped with lubricant eye drops. The vision may be slightly blurred for a few days. Rarely the lacrimal gland can be damaged by the surgery and can make the eyes more dry, so more frequent lubricating eye drops may be required
• Bleeding after the operation is usually slight and stops within a short time. If bleeding continues you should contact the hospital in case further treatment is required.
• A post-operative infection may rarely develop in the lids when they would become tender, red and more swollen and the wound may open and discharge. If this happens then you should contact the hospital as antibiotic tablets may be needed to help correct this and allow the lids to heal.
• Extremely rarely, severe bleeding can spread behind the eye that can cause loss of vision. This is why aspirin and physical exertion are discouraged for the few weeks after the operation.
